• A guide to the Health Insurance Marketplace for the uninsured

    No one plans to get sick or hurt, but everyone needs medical care at some point. Health insurance helps cover these costs and protects you from the high medical bills you might face if you have to see a specialist, have surgery or spend a few days in the hospital.

    If you don't have health coverage, the Health Insurance Marketplace is a new way to find health coverage that fits your budget and meets your needs.

    Wellmont Health System can help you understand your options. Our team of certified application counselors can guide you through the Marketplace and help you find the health insurance plan that best fits your needs.

    What is the Health Insurance Marketplace?

    The Health Insurance Marketplace helps uninsured people find health coverage. When you fill out the Marketplace application, you'll know if you qualify for private health insurance, Medicaid or the Children's Health Insurance Program, also known as CHIP. Plans available in the Marketplace and elsewhere provide free preventive care, including vaccines, screenings and check-ups. They also cover some costs for the drugs your doctor prescribes.

    Who can use the Health Insurance Marketplace?

    No matter what state you live in, you can use the Marketplace. In Virginia and Tennessee, the Marketplace is run by the federal government.

    Most people must have health coverage in 2015 or pay a penalty. Those who don't have coverage will pay an individual responsibility payment of either 2 percent of their income or $325 per adult ($162.50 per child) - whichever is higher - to the Internal Revenue Service. This penalty will increase every year.

    However, some people may qualify for an exemption to this fee.

    You're considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health benefits or some other kinds of health coverage. You may qualify for subsidized coverage, which means your health insurance premiums are lowered or paid for by financial assistance programs. Whether or not you qualify for subsidized coverage depends on your income.

    Do you still need coverage for 2015?

    You might qualify for a Special Enrollment Period

    Even though open enrollment is over, several extenuating circumstances might qualify you for the Health Insurance Marketplace Special Enrollment Period:

    • Do you need 2015 coverage because you didn’t know until after Feb. 15 that the health care law required you and your household to have health coverage, or because you didn’t understand how the requirement to have coverage would impact you and your household?
    • If yes, do you owe a fee (also called the individual shared responsibility payment) because you or someone in your household didn’t have health coverage in 2014?
    • Did you or anyone in your household lose health coverage in the past 60 days OR do you expect anyone in your household to lose health coverage in the next 60 days?
    • Did any of the following apply to you or anyone in your household in the past 60 days?
      • Got married
      • Had a baby, adopted a child or gained a dependent
      • Got released from incarceration (jail or prison)
      • Gained citizenship or lawful presence in the U.S.

    Note: This Special Enrollment Period ends Thursday, April 30.

    How can Wellmont help you?

    You don’t have to figure this out on your own. We want to help you understand your health insurance options. Your Wellmont Health System application counselors stand ready to help. Please call 1-877-421-0304 from 8:30 a.m.–5 p.m. Monday–Friday or email us with any questions or to schedule an appointment.

  • Health Insurance Marketplace Guide

    We want to help you Learn more

    Your Wellmont eligibility specialist stands ready to help you navigate your insurance choices. Please call 1-877-421-0304, or contact us with questions or to schedule an appointment.